The Observer's health editor says women ought to have C-sections instead of vaginal delivery.

[dizietsma]

\link{http://society.guardian.co.uk/health/news/0,,1723873,00.html\link to article}

I'm appalled. I haven't read it all the way through yet, but you can bet your bottom dollar I'll be writing to the Observer to complain about this shocking and irresponsible opinion piece.

Haven't had time to read the whole thread, so apologies if someone has already made the same point..
Which is... a friend of mine, who is a doctor commented that, despite spending 6 months on rotation in Obstetrics and Gynaecology, the first ever natural birth she ever witnessed was her own. As a doctor, she only ever got called in if there were complications. She found that her experience of giving birth was much better than she had expected, given what she had seen.
In other words, maybe eminent consultant obstetricians are not necessarily the best people to advise on birth options for women who are not experiencing complications.

Is your friend an OB/GYN? Or did she just do a 6 month rotation?

Well, I don't think we are all ever going to agree on this subject are we? Glad to see it's still going though! Good posts dizietsma.

uwila fgs concede that point, it is so obvious that ob/gyns have little if any day to day experience of normal, all going well births.

Exactly!

Your atttempt to discredit the worth of the OB/gyn is... well... humorous. Don't you think they learn about normal childbirth in medical school? Do you think a heart surgeon knows anything about how a normal heart works. They probably never see those.

Most midwives don't see the vaginas that their marvellous natural births may have buggered up AFTER their births.

argh. it's not about discrediting their worth and it speaks volumes about how totally unbalanced your view of this subject matter is that you would think that!

it's about their experience and their job. it is their job to intervene when necessary during pregnancy and labour to ensure the safety of the mother and child. so of course they are going to (in the main) believe that the medical model of birth is the right one...it is the one they trained to practise.

thunk

'rochwen I really enjoyed your post up until the bit where you felt the need to compare yourself with the other women at your ante natal group.'

Which bit was it that you didn't like? Was it this:

'Now, to me (and that's just my opinion after speaking to our group) is that the two of us with the scheduled c/s had the best deal and the easiest time...'

Listening to the experiences to of my fellow NHS A-N group women (and we meet every week for a coffee and we do discuss absolutely everything) that's really my conclusion and funnily enough most of the women in that group are jealous, yes that's honestly what they always say, that we 'were so lucky' to have had the c/s. The reason I felt it neccessary to compare my experience to that of the rest of the group was to illustrate that the two of us with the scheduled c/s were the ones most satisfied with their birth experience and the ones who had the least medical side-effects in our group.

I agree, of course, that it's always better to hear about experiences from people directly. So I will ask my group if any of them want to post here (I don't know if they know about mumsnet yet), so you can hear their experiences first hand.

morningpaper, as i understand it, a lot of the time trauma to the perineum occurs when there has been intervention especially induction. zero to 100 mph contractions give the vulva no chance to soften and become weird and jelly like which is what is meant to happen (i've seen it as i attended my sister when she gave birth;....it goes really really weird, like a jelly (sorry for tmi).

episiotomies also result in potentially far more serious (involving muscle) tears a lot of the time.

Most midwives? From which source do you you quote? Or is that your opinion?

Perhaps your cause and effect is backward. Perhaps they become doctors because they believe in that approach, and not the other way around.

I can agree that they have less hands on experience in an uncomplicated natural delivery (in the UK) but I don not feel that that discredits their views on the matter. Likewise, I believe midwives can hold views on caesareans enen though they have NO hands on experience of performing one.... observing perhaps.

YES! they did! so they are not in a position to have a balanced view of the birth process are they!

Quite the contrary sophable, I am arguing middle ground. My point has been that caesareans are exactly as reasonable as natural birth. That all women should have the priviledge to make their own (informed) choice. However other are arguing that natural childbirth should take precedence and pregnant women have no right ot a caesarean that is not medically required.

'exactly as reasonable' what does that mean? if that is a euphemism for 'exactly as desirable' then patently no, not for women and not for babies.

if you are arguing that c-sections should be an option for medical reasons including psychological trauma, i'm with you all the way.

but i'm not sure you are just arguing that...c-sections should not just be a choice, they are not as safe. full stop.

Uwila, in the US maybe ob/gyns DO see lots of normal births but here they generally don't, honestly, I really don't think we're wrong about that! They see the problems, many, many normal uncomplicated births happen with just midwives present.

I love this topic, because you always get such great debate . I've had 2 cs, and one normal birth. Everyone's experience is different - my first cs was a mare, the second was physically good, but my normal birth after the 2 was by far the best of all. Having done it both ways, I know that FOR ME the very best thing is normal, natural birth. I'm not a knit-your-own-yoghurt type, far from it, but giving birth is literally the best thing my body has ever done, and I said straight away after that I would do it again tomorrow. She was over 10lbs, and I had a small tear that healed naturally, gas & air. Not all births are traumatic, just as not all cs are traumatic. But the risks of cs and the recovery period just don't make it a natural alternative to normal birth as far as I am concerned. What are the health benefits to baby and mother? I haven't seen a single argument that convinces me cs is safer, here or elsewhere.

People have said midwives don't see the after effects of normal birth. I would argue they do: its the midwife that comes to see you after the birth, checks your piles and any tears, sees you at the babies 1st birthday ... maybe I'm very lucky, but I still see mine around town and she pops in every now and again. So she knows exactly how things are.

No consultant ever turned up on my doorstep for coffee and a chat, or even offered a debrief.

I think Uwila has hit the nail on the head with this:
'My point has been that caesareans are exactly as reasonable as natural birth.'

I finally managed to read through the whole thread and I have to say that I'm a bit puzzled by the strong, and initally very very negative, reacion to this article. I don't understand why people are so against women choosing to have elective c/s? What's the problem? It's a birth choice like any other. Would anybody get so upset about an article promoting homebirth (which isn't without risks either)?

Seriously, why is this such a contentious issue?

Agree sophable, re sections. I think medically necessary = ok, just because you feel like it (and I don't count previous birth trauma or other serious psychological reason here) = shouldn't be offered. I don't think women should be able to say 'well, I've never done childbirth before and I know I'm having an uncomplicated normal pregnancy but I'd rather take the higher risks to me and my baby and have a section because ' because I've heard how scary and painful it is and I just don't feel like doing it thanks.' I really don't. Now, if someone can tell me that a c section is statistically AS SAFE as vaginal birth (and everything quoted here so far suggest is IS NOT) then maybe I'll change my mind.

So I don't think c sections as AS REASONABLE as vaginal birth because they are not as safe.

Rochwen, it's a contentious issue because:

The WHO says c sections oughtn't be over 10%
They're at 25% in the UK and 90% in Brazil and
They're NOT AS SAFE as vaginal birth for mothers and babies

Well, that's my pov anyway. But the origial article was proposed that c sections SHOULD be routinely offered to all women and presented as being as safe as vaginal birth. and they're not.

Ok, when they prepped me for my scheduled c/s they told me (because I asked lots and lots of questions) that statistically a scheduled c/s is the safest form of delivery for both mother and child. Full stop. The reason why statiscally a c/s is 4% less safe than a vaginal birth is that emergency sections are usually done when something is really wrong. That affects the statistics.

I have no medical training but I am an academic and had to study statistics for my PhD and this is how I understood it.

If you compare scheduled (elective) c/s to all vaginal births than it is statistically the safest option. If you compare all c/s (including the emergency ones) to all vaginal births then the vaginal births are statistically the safest option.

(I hope that makes sense.)

Of course it would be interesting to discuss what the definition of 'safest' is. Is it maternal mortality or infant mortality, is it after or side effects, the woman's perception of how the side-effects affect her life.

Does that convince you, WWW? I have to admit that I'm very sad that you will not allow a woman the choice of a c/s. The woman who makes the choice has to live with the risks and therefore it is her decision and hers alone. What effect does a woman choosing a c/s on your life? Why can't it be just live and let live. If choosing a c/s makes the life for another woman easier or happier then why not cheer her on?

why are you pro c-section lot so obsessed with vaginas?

its making me lol